Pelvic Floor Massage: A Comprehensive Guide to Improve Pelvic Health

When we refer to the “pelvic floor”, we’re referring to the muscles that support your pelvic organs. When individuals begin to experience symptoms of pelvic floor dysfunction, a recommended form of treatment is pelvic floor massage which is a part of pelvic floor physical therapy treatment.

The concept of pelvic floor massage is to re-train the muscles and restore strength in weakened areas and reduce discomfort in areas that are painful to touch. With one in three women experiencing pelvic floor dysfunction at some point in their lifetime, pelvic floor massage can be one way to treat these symptoms and improve overall pelvic floor health.

Understanding the Pelvic Floor

The pelvic floor is located between your coccyx and the pubic bone within your pelvis, and this group of muscles support the pelvic organs around it (bladder, uterus, vagina and bowel). They will contract and relax as necessary and your ability to do this will depend on the overall health and strength of your pelvic floor muscles.

The overall health and strength of the pelvic floor can change due to life events such as pregnancy, or ageing. In a survey of 2000 women, over half of the women had experienced pelvic floor dysfunction symptoms and 39% of them thought these symptoms were normal. It’s important to be aware of what the symptoms are so you can recognise them if you start to notice this happening. Some symptoms of pelvic floor dysfunction can be:

• Urinary incontinence
• Faecal incontinence
• Painful intercourse
• Lower back pain
• Constipation
• Pelvic organ prolapse

Although it’s important to recognise these symptoms, it’s even more important to speak with a pelvic floor specialist so they can put together a treatment plan for you. Early intervention is key to recovering your pelvic floor health so the symptoms do not begin to affect your quality of life. Alongside pelvic floor massage, a specialist may recommend specific pelvic floor exercises using Kegel weights, such as the Bodyotics Kegel Balls, as a way of enhancing your pelvic floor health

Pelvic Floor Physical Therapy: Benefits of Pelvic Floor Massage

Although the pelvic floor is a group of muscles, pelvic floor physical therapy treats the bones, cartilage, ligaments, connective tissues, and tendons in this area. The treatments that make up this type of therapy, such as pelvic floor massage, are aimed at improving overall pelvic floor health and reducing the severity of pelvic floor dysfunction symptoms.

Like all muscles, over time they can lose their strength and tone if they are not exercised, and the pelvic floor is no different. As women age or go through pregnancy and labour, the pelvic floor can change quite dramatically, however if you are practised and regularly do pelvic floor exercises, your pelvic floor health will be in a much better position to handle the changes that come your way.

Putting the stigma around pelvic floor massage aside, it is a popular treatment method used within pelvic floor physical therapy. Not all exercises require internal massage, as some of these are done externally. Pelvic floor massage can help to stretch and improve the mobility of the muscles, so they learn to relax rather than contract, which in turn improves urinary and faecal functions in the bladder and bowel. Imagine sneezing without having to cross your legs first!

Some people experience chronic pain in their pelvis and pelvic floor region which can affect one's quality of life and ease of doing everyday activities. Simple pelvic floor massage techniques can reduce pain points and re-associate parts of the pelvic floor that were once painful into a more positive feeling. This is called sensory integration.

Learn more: How to Relieve Pelvic Pain During Pregnancy

For women who are in the postpartum phase after giving birth, their body and pelvic floor will take time to recover and for most first-time mothers, noticeable improvements can be seen a year after the birth. Wearing a support band such as Lola&Lykke’s Core Restore Postpartum Support Band can aid your recovery after birth to support your core, and pelvic floor, as you recover from pregnancy and labour. It also helps to alleviate any pressure in your lower back by correcting your posture and engaging your core muscles whilst your body is still recovering from the birth, which in turn positively affects your pelvic floor and aiding the recovery there too.

How do I know if I need a pelvic floor massage?

Normally, people turn to pelvic floor specialists when they experience symptoms of pelvic floor dysfunction and it’s affecting their ability to carry out everyday activities. Here are some, but not limited to, pelvic floor dysfunction symptoms that may lead to a specialist advising pelvic floor massage as a way forward to specifically treat certain areas of your pelvic floor.

• Painful urination
• Urinary or faecal incontinence
• Constipation
• Pelvic pain
• Pelvic muscle spasms
• Vaginismus (involuntary pelvic floor muscles contracting and spasming during vaginal penetration)
• Tailbone pain
• Pelvic organ prolapse
• Postpartum issues
• Chronic pain near the vagina (Vulvodynia)
• Bladder pain

Lesser obvious symptoms like urgently needing to urinate or needing to urinate more frequently are also a sign that you may be experiencing pelvic floor dysfunction. You can also feel pain in your lower back which can mask potential issues with your pelvic floor if it’s ignored.

Some lifestyle factors can affect the performance of your pelvic floor and if you engage in any of these for a long or consistent period of time, you may want to consider getting a pelvic floor check-up to assess the overall health of your pelvic floor.

• High-impact exercises such as running and rebound classes can weaken your pelvic floor over time because of the pressure it endures during these workouts.
• Sitting for long periods of time can compress your pelvic organs and put additional pressure on your core and pelvic floor muscles.
• As you progress through pregnancy, your growing baby will apply pressure to your pelvic organs as it gets bigger and needs more room! The process of labour can also cause pelvic floor muscles to weaken as they are stretched, and sometimes torn, during birth.

Learn more: Lola&Lykke Experts answer: What is a Pelvic Floor Check-up, and why you need it

How to Perform Pelvic Floor Massage

You are not alone in thinking, “Is this muscle pelvic floor? Where is it? I can feel something but is that it?”. A lot of women, even those attending pelvic floor exercise classes, are sometimes unsure of what they should feel when exercising or massaging the pelvic floor. So in case you’re wondering how you can learn to do this, here is a simple step-by-step guide on how to perform a pelvic floor massage.

• Get yourself comfortable with blankets and pillows for support. You want to feel relaxed, so set up the space so it allows you to feel calm - it’s no different than if you were going to a spa for a massage!
• Lay on your back or on your side comfortably so you can access your vagina.
• Start by breathing in so your tummy expands and breathing out slowly through your nose. This will naturally relax your pelvic floor. Continue doing this until you are ready to insert your index finger and thumb as you exhale.
• Insert your index finger and thumb into your vagina and move your finger down the sides of the pelvic muscles with a gentle pressure applied. (Avoid touching the urethra and rectum).
• The aim is to “map” out your pelvic muscles with touch and learn where you feel any pain, if at all. Through touch you can increase the connectivity with your pelvic muscles.
• You can try adding a deeper pressure as you explore further to the sides of the vagina. As you notice trigger points or areas which are more tender, move your finger in small circular motions to help relieve any tension.
• Notice how your body responds to touch in certain areas and only do what feels good. If the massage starts to feel painful at any point, try reducing the pressure or do lighter massage strokes.
• If you find an area that is more tender, slow your breathing down and use gentle massage strokes, as long as this is comfortable to continue.

If you’re not sure how to locate your pelvic floor muscles, this short video explains where the muscles sit and how you can learn to feel them.

For further information about how to perform pelvic floor massage, ask one of our pelvic floor physiotherapists on our Experts Panel.

Pelvic floor massage tools and techniques

To support your pelvic floor massage, there are different tools that you can use to assist you. Pelvic floor physiotherapists will recommend tools such as pelvic wands, vaginal or rectal dilators, and lubrication. The tool you choose to use will depend on what your diagnosis and symptoms are so you can access those trigger points.

Pelvic floor wands are long, curvy silicone tools that can be used to explore different pelvic floor muscles internally. There are also tools such as biofeedback devices which can measure muscle electrical activity to see which muscles are active/inactive or weaker/tighter than others. You can also try using massage therapy balls to gently massage the external areas of your pelvic floor.

Pelvic floor massage techniques

• Myofascial Release: This technique involves sustained pressure on the myofascial connective tissue to release muscular tightness and improve flexibility. Myofascial release can be applied externally or internally with the use of tools.
• Trigger Point Therapy: Focused pressure is applied to areas of tightness within the pelvic floor muscles to alleviate pain and tension.
• Stretching and Relaxation Exercises: Try gentle stretching, such as moving your knees side to side or sitting in yoga poses, can help you to feel relaxed and reduce overall tension.
• Breathing Techniques:Mindful breathing during pelvic floor massage helps you to relax the muscles and release tension. It can also help you to focus on the massage giving you a deeper connection to what you can feel.
• Warm-Up and Cool Down:Just like any other form of exercise, pelvic floor massage benefits from a proper warm-up and cool-down. Gentle warm-up exercises and gradual introduction of pressure prepare the muscles for massage, while a cool-down helps prevent any post-massage discomfort.

Exercises and Stretches for Pelvic Floor Health

Pelvic floor exercises have been proven to improve pelvic floor health and reduce severity of pelvic floor dysfunction symptoms. The exercises can be done anywhere, anytime and it’s even better if you can start to incorporate these into your daily routine for consistency. Repeating these exercises over time, when you’re doing them properly, will give you noticeable results. Some people start to notice a change after 3 months of consistently performing pelvic floor exercises. You can also use a pelvic floor trainer to enhance your workout.

Pelvic floor exercises to try

Before starting any exercises, it’s a good idea to empty your bladder so you can fully relax and engage in the exercises. Make sure you are sitting or lying comfortably and you have a Kegel weight handy if you want to incorporate this into your routine.

• Tighten your pelvic floor muscles for a count of ten.
• Relax the muscles for a count of ten.
• Try breathing in as you relax your pelvic floor and tighten as you breath out.
• Repeat this up to ten times, up to three times per day.

Kegel exercises are effective to do alongside pelvic floor massage to improve your results and overall pelvic floor health. The Bodyotics Deluxe Kegel Weighted Exercise Balls have varying sizes and weights, so you start with the lightest Kegel weight and work your way up to the heavier Kegel weight. Explore valuable guidance and tips on Kegel exercises in the Complete Guide to Kegel Exercise for comprehensive insights into optimizing your pelvic floor health.

It’s important to note that before you start to do any pelvic floor exercises, you must seek advice from your doctor or a pelvic floor specialist so that they can suggest the correct treatment plan for your symptoms. For example, if you have a hypertonic pelvic floor, you may be advised to reduce or stop doing exercises such as squats, crunches, or planks to prevent further strain on your pelvic muscles.

Low impact stretches for tight pelvic floor

Especially if you have a hypertonic (tight) pelvic floor, low-impact stretches such as Yoga poses can help you improve mobility whilst managing your pelvic floor symptoms. By doing exercises like this, you can still work out and keep active without doing any high-impact exercises.

When choosing stretches and routines to follow, you want to avoid doing anything that puts a strain on your pelvic floor muscles. Doing so will only cause further strain and damage to this muscle group.

Stretches to strengthen the pelvic floor

Kegel weights and Kegel ball exercises are an effective way to strengthen the pelvic floor muscles. We can use weights to strengthen other muscles in our body, so why not your pelvic floor? You can do Kegel exercises sitting, laying, or standing up, however if your pelvic floor is weak, you may want to try this laying down first. You can try this sample Kegel exercise routine to get used to how they feel and to know if you are doing them properly.

Ask for support

When it comes to managing your pelvic floor health, you need to take a comprehensive approach. Seeking support from a healthcare professional to diagnose symptoms early on, and start a treatment plan including pelvic floor massage and exercises, will mean that you can start to reap the benefits of improved pelvic floor health.